NPIMap

Organization Active NPI

Northeast Surgical Specialties, LLC

Doing business as Piedmont Orthopedic Specialists - Poplar Tent

  • Orthopaedic Surgery Physician
  • Concord, NC
National Provider Identifier
1730410192
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NORTHEAST SURGICAL SPECIALTIES, LLC
Doing business as
Piedmont Orthopedic Specialists - Poplar Tent
Practice address
5651 Poplar Tent Rd
Suite 200
Concord, NC 28027-7530
Phone
(704) 403-7020
Fax
(704) 403-7039
NPI assigned
Jan 26, 2010
Last updated
Jan 26, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHEAST SURGICAL SPECIALTIES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas F Laymon
Title
Sr VP
Phone
(704) 403-2276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

5651 Poplar Tent Rd
Suite 200
Concord, NC 28027-7530

Mailing address

5651 Poplar Tent Rd
Suite 200
Concord, NC 28027-7530
Phone (704) 403-7020

Other identifiers 3

IdentifierTypeStateIssuer
5914068MedicaidNC
DO1210OtherNCRAILROAD MEDICARE PTAN
2342616OtherNCMEDICARE PTAN, GROUP

Other names 1

  • Piedmont Orthopedic Specialists - Poplar Tent Doing business as

National Provider Directory

National Provider Directory
Part of
Northeast Surgical Specialties LLC

Locations

1090 NE Gateway Ct NE
Ste 204
Concord, NC 28025
Phone (704) 403-7020

5651 Poplar Tent Rd
Ste 200
Concord, NC 28027
Phone (704) 403-2275

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1730410192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 POPLAR TENT RD",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277530",
            "telephone_number": "704-403-7020",
            "fax_number": "704-403-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 POPLAR TENT RD",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277530",
            "telephone_number": "704-403-7020",
            "fax_number": "704-403-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST SURGICAL SPECIALTIES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST SURGICAL SPECIALTIES, LLC",
        "enumeration_date": "2010-01-26",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "704-403-2276"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5914068",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DO1210",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN, GROUP",
            "identifier": "2342616",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Orthopedic Specialists - Poplar Tent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.